Effects of hydroxychloroquine and azithromycin use on ECG parameters due to COVID-19 in pediatric patient population

Year 2023, , 206 - 214, 31.12.2023

Celal Varan , Hatice Uygun , Mehmet Turğut

https://doi.org/10.30569/adiyamansaglik.1313270

Abstract

Aim: Due to COVID-19 infection, the use of two drugs, hydroxychloroquine and azithromycin, with a high potential for arrhythmia, came to the fore in the pediatric patient group at the beginning of 2020, during the search for treatment. The aim is to reveal the synergistic arrhythmic effects of these two drugs in prolonging the QT interval on the ECG.
Materials and Methods: First of all, patients taking hydroxychloroquine were identified. Demographic data of these patients were recorded. In addition to hydroxychloroquine, azithromycin and other treatments they used were also recorded. Those with ECG data were selected. Transmyocardial repolarization parameters calculated by ECG were calculated retrospectively (QT, QTc, Tpe, Tpe/QT, Tpe/QTc). Then, laboratory findings and radiological imaging of these patients were recorded.
Results: Twenty-three pediatric patients who met the study criteria were identified. All of the patients were asymptomatic or mild disease. When initial and post-drug ECG parameters were compared; It was observed that the drugs did not have a significant arrhythmogenic effect on ECG parameters, especially QT interval and QTc.
Conclusion: Unlike the literature showing arrhythmic effects of these drugs in adult COVID-19 disease, hydroxychloroquine and azithromycin did not show such an effect in the pediatric population.

Keywords

COVID-19, ECG, QTc, Pediatrics, Arrhythmia

Ethical Statement

Ethics committee approval was obtained with the decision of the Ethics Committee for Non-Interventional Procedures of Adıyaman University, dated and numbered 2020: 8/11. The study was conducted under the principles of the Declaration of Helsinki.

Supporting Institution

No person/organization is supporting this study financially.

Project Number

yok

Pediatrik hasta popülasyonunda COVİD-19 sebebiyle hidroksiklorokin ve azitromisin kullanımın EKG parametreleri üzerine etkileri

Abstract

Amaç: COVID-19 enfeksiyonu nedeniyle, 2020 yılının başında tedavi arayışı sırasında aritmi potansiyeli yüksek hidroksiklorokin ve azitromisin isimli iki ilacın kullanımı pediatrik hasta grubunda gündeme geldi. Amaç bu iki ilacın EKG üzerinde QT intervalini uzatmadaki sinerjistik aritmik etkilerini ortaya koymaktır.
Gereç ve yöntem: Öncelikle hidroksiklorokin alan hastalar tespit edildi. Bu hastaların demografik verileri kaydedildi. Hidroksiklorokine ilaveten kullandıkları azitromisin ve diğer tedavileri de kayıt altına alındı. EKG verileri olanlar seçildi. EKG ile hesaplanan transmiyokardiyal repolarizasyon parametreleri retrospektif olarak (QT, QTc, Tpe Tpe/QT, Tpe/QTc) hesaplandı. Ardından bu hastaların laboratuvar bulguları ve radyolojik görüntülemeleri kaydedildi.
Bulgular: Çalışma kriterlerine uygun 23 pediatrik hasta tespit edildi. Hastaların tamamı asemptomatik ya da hafif hastalık tablosundaydı. Başlangıç ve ilaç sonrası EKG parametreleri karşılaştırıldığında; başta QT intervali ve QTc olmak üzere EKG parametreleri üzerine ilaçların belirgin bir aritmojenik etkisi olmadığı görüldü.
Sonuç: Erişkin COVİD-19 hastalığında bu ilaçların aritmik etkilerini gösteren literatüründen farklı olarak, hidroksiklorokin ve azitromisin böyle bir etkiyi pediatrik popülasyonda göstermediler.

Keywords

COVİD-19, EKG, QTc, Pediatri, Aritmi

Ethical Statement

Ethics committee approval was obtained with the decision of the Ethics Committee for Non-Interventional Procedures of Adıyaman University, dated and numbered 2020: 8/11. The study was conducted under the principles of the Declaration of Helsinki.

Supporting Institution

No person/organization is supporting this study financially.

Project Number

yok

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